Abstract: Objective To observe the effect of sitz bath with Xiaozhi Decoction on wound pain, and edema relief, and healing after external dissection and internal ligation in patients with mixed hemorrhoids. Methods A total of 104 patients with mixed hemorrhoids admitted from April 2023 to November 2025 were prospectively selected for the study. Patients were assigned into a control group and a study group based on propensity score matching results. After external dissection and internal ligation, the control group （n=52） received conventional treatment combined with potassium permanganate sitz bath, while the study group （n=52） received conventional treatment plus sitz bath with Xiaozhi Decoction. The two groups were compared regarding postoperative wound edema and pain scores, healing quality, symptom relief time, and anal function. Results From the 3rd day after surgery, the study group had lower wound pain and edema scores and a lower incidence of complications than the control group （P<0.05）. The wound symptom relief time and healing time were also shorter in the study group than in the control group, and the first-class wound healing rate was higher in the study group （P<0.05）. The Wexner scores at 2 and 4 weeks after surgery were lower in the study group than in the control group （P<0.05）. Conclusion The combined treatment of external dissection and internal ligation followed by sitz bath with Xiaozhi Decoction is beneficial for postoperative perianal wound healing and early pain and edema relief in patients with mixed hemorrhoids, and can promote the recovery and improvement of anal function after surgery.

Key words: Mixed hemorrhoids, External dissection and internal ligation, Xiaozhi Decoction, Postoperative treatment, Wound healing